接受维布妥昔单抗治疗后的长期缓解者：复发难治性霍奇金淋巴瘤和间变性大细胞淋巴瘤患者的单中心经验
Long-Term Responders After Brentuximab Vedotin: Single-Center Experience on Relapsed and Refractory Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma Patients.
作者信息
Gandolfi Letizia, Pellegrini Cinzia, Casadei Beatrice, Stefoni Vittorio, Broccoli Alessandro, Tonialini Lorenzo, Morigi Alice, Argnani Lisa, Zinzani Pier Luigi
机构信息
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy
出版信息
Oncologist. 2016 Dec;21(12):1436-1441. doi: 10.1634/theoncologist.2016-0112. Epub 2016 Aug 2.
BACKGROUND
Brentuximab vedotin (BV) has shown high overall response rate in refractory/relapsed Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL) with reported long-term response duration in clinical trials, but few data are available regarding its role in long-term outcomes in real life.
PATIENTS AND METHODS
A single-center observational study was conducted on patients treated with BV in daily clinical practice to evaluate the long-term effectiveness of BV in HL and sALCL patients and to check whether clinical trial results are confirmed in a real-life context.
RESULTS
The best response rate in the treated 53 patients (43 HL and 10 sALCL) was 69.8% (with 46.5% complete response [CR]) in HL and 100% (80% CR) for sALCL, respectively. With a median patient follow-up of 36.8 months, the estimated median duration of response was 31.5 months for HL and 17.8 for sALCL, respectively. At the latest available follow-up, 75% of patients were still in response, with 43% without any consolidation. Toxicity was primarily neurological and it was rarely so serious to require dose reduction or interruption. In addition, it always reversed completely after the end of treatment.
CONCLUSION
Our data showed that 51% of patients treated with BV can be regarded as "long-term responders." Among these cases, for all patients who underwent stem cell transplantation immediately after BV, the procedure was consolidative. For patients who have remained in continuous CR without any consolidation after therapy, BV can induce prolonged disease control.
IMPLICATIONS FOR PRACTICE
Brentuximab vedotin (BV) has shown a high overall response rate in refractory/relapsed Hodgkin lymphoma and systemic anaplastic large cell lymphoma, with reported long-term response duration in clinical trials, whereas few data are available regarding its role in long-term outcomes in real life. The data reported in this study suggest that BV can induce the same results in daily clinical practice. The data showed that 51% of patients treated with BV can be regarded as "long-term responders." Among these cases, BV can induce prolonged disease control in patients who have remained in continuous complete response without any consolidation after the drug.
背景
在难治性/复发性霍奇金淋巴瘤（HL）和系统性间变性大细胞淋巴瘤（sALCL）中，维布妥昔单抗（BV）已显示出较高的总体缓解率，临床试验报告其缓解持续时间较长，但关于其在现实生活中长期预后中的作用的数据较少。
患者与方法
在日常临床实践中对接受BV治疗的患者进行了一项单中心观察性研究，以评估BV在HL和sALCL患者中的长期有效性，并检查临床试验结果在现实生活中是否得到证实。
结果
在接受治疗的53例患者（43例HL和10例sALCL）中，HL的最佳缓解率为69.8%（完全缓解[CR]率为46.5%），sALCL为100%（CR率为80%）。患者的中位随访时间为36.8个月，HL和sALCL的估计中位缓解持续时间分别为31.5个月和17.8个月。在最近一次随访时，75%的患者仍处于缓解状态，其中43%未接受任何巩固治疗。毒性主要为神经毒性，很少严重到需要降低剂量或中断治疗。此外，在治疗结束后毒性总是完全逆转。
结论
我们的数据显示，接受BV治疗的患者中有51%可被视为“长期缓解者”。在这些病例中，对于所有在BV治疗后立即接受干细胞移植的患者，该手术具有巩固作用。对于治疗后未接受任何巩固治疗而一直处于持续CR状态的患者，BV可诱导疾病得到长期控制。
对实践的启示
维布妥昔单抗（BV）在难治性/复发性霍奇金淋巴瘤和系统性间变性大细胞淋巴瘤中已显示出较高的总体缓解率，临床试验报告其缓解持续时间较长，而关于其在现实生活中长期预后中的作用的数据较少。本研究报告的数据表明，BV在日常临床实践中可产生相同的结果。数据显示，接受BV治疗的患者中有51%可被视为“长期缓解者”。在这些病例中，BV可使药物治疗后一直处于持续完全缓解且未接受任何巩固治疗的患者的疾病得到长期控制。
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